When I was 14 years old, I decided my goal in life was to get a 6-pack.

“Why?” you ask.

In gym class, as a part of our weightlifting unit, we were told to do 40 v-ups in as few sets as possible.  Guess how many I did?


That was it.  I thought I was going to die.  My midsection burned like crazy.

More importantly, I was mortified as my classmates ripped off seemingly endless v-ups around me.

So, I vowed to obtain that 6 pack and do my v-ups religiously. Suddenly, 40 v-ups weren’t difficult.  I moved to 50, then 60, and then 70 consecutively.

I accidentally stumbled upon what would become one of my life’s passions: gaining muscle.

I’m here to give you some of the Do’s and Don’ts with respect to gaining muscle while staying lean and maintaining a great A1c at the same time.

How to build muscle with type 1 diabetes

Do: Eat a caloric surplus

Contrary to what anyone may try to tell you, resistance training and type 1 diabetes mix, and they mix very well. You can find countless reasons in the archives on this site.

But for gaining weight, especially muscle mass? It’s about balance.  Balance, patience, and consistency.

No matter how you slice it, weight gain of any type, muscle included, requires a caloric surplus. Why? Because you’re creating new tissue. You can’t create something out of nothing.

You need inputs (calories) to create outputs (lean muscle mass).

Let me repeat: you will NOT gain weight OR muscle if you are NOT in a caloric surplus.

However, don’t let this fool you: the “See Food” approach of “I see it, I eat it, with no regard to caloric content except for the insulin I take” is not the optimal way to gain weight. You’ll be chasing high and low blood sugars constantly with the massive amounts of insulin you’ll be taking, and the majority of the weight you gain will be fat.

I personally prefer a slower, more methodical approach to weight gain. Put simply, you determine your caloric maintenance – how many calories are required for maintaining body weight – and then add 200-300 calories or 5-10% of total calories on top of that number.

You can learn how to easily find your caloric maintenance level in this post!

Don’t: Rush the process

Why so conservative?

Muscle gain is not linear or fast

If your resistance-training program is doing its job, you should be making steady progress in the gym during this time in a caloric surplus, whether it is increases in your load (amount of weight you are using) or increases in your volume (sets and reps).

However, in ideal conditions, the maximum amount of muscle you can build in a week is ½ lb. That’s assuming everything is PERFECT. Women, cut that number in half.  That rate is for new lifters: the more experienced you are, the slower that rate will be.

That being said, why overload your body with excess calories if only a moderate percentage will turn into the lean mass you desire?

Less fat gain

Raise your hand if you enjoy insulin resistance, decreased levels of testosterone (with corresponding increases in estrogen), and making life more difficult for yourself for no reason.

No one? That’s what I thought.

Too high a surplus leads to more fat gain, which activates the aforementioned mechanisms, which primes the body to lay down even MORE fat while making it tougher to add muscle.

Slow and steady wins this race.

Easier to manage blood sugar levels

In my experience, it is quite a bit simpler to factor in a modest increase in calories into my insulin-dosing regimen than a huge increase.

While the occasional day of a 1000+ caloric surplus is doable and manageable, it’s a lot more playing catch up of blood sugars on the back end – the spikes are higher, the crashes are lower, and insulin sensitivity changes through the day and even by the meal.

Throw in some meals where the macros are a mystery, and let the roller coaster ride begin!

strength training with diabetes

Do: Eat enough protein

Protein consumption aids in satiety, muscle protein synthesis, recovery from workouts, post-meal blood sugars, and a myriad of other benefits that could be a whole separate article.

To make a long story short: you need it to be at your best, and you need it in adequate amounts.

No, you won’t need to eat pounds of meat or drink six shakes a day. Without boring you with too much biochemistry and research, the American College for Sports Medicine recommends a daily intake of 0.5-0.8g/lb (1) and multiple studies recommend 0.6-0.8g/lb (2, 3, 4), with no real benefit beyond 0.8g/lb.

Don’t: Worry about being perfect

Nothing feels worse than having your diet absolutely on point for the day, testing your blood sugar at 1130pm, being 54, and eating what seems like everything in the house.

We have type 1 diabetes. Life happens. Your blood sugars may run high one day and you may not hit your caloric goal, or you may have a low and overeat.

Do not stress, my friends. That solves nothing and actually may make your blood sugars worse.

Diabetes control comes before anything else. To perform at our best in the gym, on the field, or wherever we may be, blood sugar management is the key to success. If everything is haywire, forcing things will get us nowhere.

Remember: your calories are like a bank – if you withdraw too much one day, make up for it the next day by reducing calories a little. If you undereat one day, eat a little more the next day. This principle can be applied to both muscle gain and weight loss.


This is simply an introduction, but at the end of the day, the key is finding what method works the best for YOU.

PS:  That 14-year-old kid? He achieved his goal.

Suggested next post: How to lose weight when you live with diabetes


(1) https://www.acsm.org/docs/default-source/files-for-resource-library/protein-intake-for-optimal-muscle-maintenance.pdf

(2) https://www.ncbi.nlm.nih.gov/pubmed/22150425

(3) http://bjsm.bmj.com/content/early/2017/08/08/bjsports-2017-097608.full

(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2129168/